Identification and Characterization of Vena Cava Filters

Purpose	Tool to automatically identify and characterize (type, location, potential complications) vena cava filters on imaging studies.
Tag(s)
Panel	Interventional Radiology
Define-AI ID	19090001
Originator	Jeremy C. Durack, MD
Lead	Jeremy C. Durack, MD
Panel Chair	Jeremy C. Durack, MD; Rajesh Shah, MD
Panel Reviewers	Interventional Radiology Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES104

Clinical Implementation

Value Proposition

The majority of vena cava filters placed today are retrievable, though it is known that filters are often not retrieved even when clinically appropriate. Identification and documentation of filter presence could trigger inclusion on a patient's problem list to encourage discussion regarding appropriate and timely retrieval. In addition, complications such as migration, fracture, thrombosis, and vena cava perforation are well known and detection may be facilitated using using machine learning techniques.

Narrative(s)

A patient with a history of deep venous thrombosis had a filter placed pre-operatively. The patient recovered from the procedure and has restarted anticoagulation. The mechanical filter is no longer required, however due to transitions of care teams, no one has taken responsibility for filter management. This tool would help to identify the presence of a filter and that information could be used to trigger appropriate management discussions as well as alert clinicians to potential filter-related complications.

Workflow Description

Abdominal x-ray or CT imaging of the abdomen performed. Automated detection of a filter, matched against training set of filters to determine type and location relative to the renal veins/vertebral bodies.

Considerations for Dataset Development

Procedure(s)	X-ray abdomen, CT abdomen
View(s)	All
Sext at Birth	Male, Female
Age	All
Indications for filter	varied
Filter indwelling time	varied
Filter Location	varied (see locations below in technical specifications)
Filter type	varied (see types below in technical specifications)
Filter injection route	varied

Technical Specifications

Inputs

DICOM Study

Procedure	X-ray, CT abdomen
Views	All
Data Type	DICOM
Modality	X-ray, CT
Body Region	Abdomen
Anatomic Focus	Vena cava
Pharmaceutical
Scenario	MRI may have limited utility in filter assessment due to metallic artifcacts

Primary Outputs

Filter Present

RadElement ID	RDE649
Definition	Presence of filter(s)
Data Type	Categorical
Value Set	Absent Present Unknown
Units	N/A

Filter Component count

RadElement ID	RDE646
Definition	Count of filter components
Data Type	Numeric
Value Set	N/A
Units	Number of components

Filter Type

RadElement ID	RDE651
Definition	For each filter identified, return the type of filter
Data Type	Categorical
Value Set	Option Elite filter Gunther tulip filter Celect filter ALN filter G2 filter G2 X filter Eclipse filter Meridian filter Sentry filter OptEase filter TrapEase filter Recovery Option filter Denali filter VenaTech - LGM filter VenaTech - LP filter VenaTech Convertible filter Simon Nitinol filter Greenfield filter - stainless steel Greenfield filter - titanium Bird’s Nest filter Other
Units	N/A

Filter or filter component location(s)

RadElement ID	RDE652
Definition	Anatomic location of filter(s) or filter component(s)
Data Type	Categorical (multi-select)
Value Set	Infrarenal vena cava suprarenal vena cava right common iliac vein left common iliac vein right testicular vein left testicular vein right ovarian vein left ovarian vein right renal vein left renal vein Superior vena cava right atrium right ventricle left ventricle interventricular septum main pulmonary artery right main pulmonary artery left main pulmonary artery segmental right pulmonary artery segmental left pulmonary artery other
Units	N/A

Secondary Outputs

Filter Complications

RadElement ID	RDE653
Definition	Radiographically evident filter complications
Data Type	Categorical (multi-select)
Value Set	Filter thrombosis Filter tilt Filter perforation Filter fracture Filter migration Pulmonary embolism Filter associated infection Filter malposition Incomplete deployment
Units	N/A

Future Development Ideas

Include features like:

Change of filter component location over time
Distinguish features of multiple filters or filter components present